A nurse is caring for a client who experienced a lacerated spleen and has been on bedrest for several days. The nurse auscultates decreased breath sounds in the lower lobes of both lungs. The nurse should realize that this finding is most likely an indication of which of the following conditions?

A. Fresh frozen plasma: Fresh frozen plasma contains clotting factors, including factor VIII, but it is not the primary treatment for hemophilia A. While it can be used in emergency situations to temporarily increase clotting factor levels, it is not typically administered prophylactically before dental procedures.
B. Recombinant factor VIII: This is the correct answer. Recombinant factor VIII is the treatment of choice for individuals with hemophilia A. It is administered to replace the deficient factor VIII in the blood, thereby promoting clot formation and preventing excessive bleeding during surgical procedures such as wisdom teeth extractions.
C. Packed red blood cells (RBCs): Packed red blood cells are not typically indicated for the treatment of hemophilia A. While they may be necessary if significant blood loss occurs during the procedure, the primary treatment is replacement of the deficient clotting factor.
D. Prophylactic antibiotics: Prophylactic antibiotics may be prescribed to prevent infection following dental procedures, especially in individuals with bleeding disorders who are at increased risk of infection due to compromised immune function. However, the primary treatment for hemophilia A prior to dental procedures is replacement therapy with clotting factor concentrates like recombinant factor VIII.

A. Increase hematocrit: Fluid overload typically leads to hemodilution, resulting in a decrease in hematocrit rather than an increase. Therefore, an increase in hematocrit would not be expected in a client with fluid overload.
B. Increased temperature: Fluid overload is not typically associated with an increased body temperature. Instead, fever may indicate an infection or another underlying cause. Therefore, an increased temperature would not be a typical finding in a client with fluid overload.
C. Increased heart rate: Fluid overload can lead to an increased heart rate as the body attempts to maintain adequate cardiac output in the presence of excess fluid volume. An elevated heart rate is a compensatory mechanism to maintain tissue perfusion despite the increased workload on the heart.
D. Increased respiratory rate: Fluid overload can cause pulmonary congestion, leading to increased respiratory effort and a higher respiratory rate as the body attempts to compensate for decreased gas exchange efficiency. An increased respiratory rate helps to improve oxygenation and remove excess carbon dioxide from the body.
E. Increased blood pressure: Fluid overload often leads to increased blood pressure due to the increased volume of circulating blood, which can strain the cardiovascular system. Elevated blood pressure is a common manifestation of fluid overload and reflects the increased workload on the heart and blood vessels.